Permit CITY OF rTM1 IGARD BUILDING PERMIT
P ERMIT #: BUP2003 -00614
A DEVELOPMENT SERVICES DATE ISSUED: 7/22/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S111 CD 00300
SITE ADDRESS: 15750 SW 98TH AVE ADM. BLDG.
SUBDIVISION: ALDERBROOK FARM ZONING: R -7
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: FPS FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 10,860.00
Remarks: Fire sprinkler system for new administrative building.
Owner: Contractor:
TIGARD CHURCH OF GOD A PROFESSIONAL FIRE SYSTEMS
15670 SW 98TH AVENUE 17273 S STEINER ROAD
TIGARD, OR 97223 BEAVERCREEK, OR 97004
Phone:
Phone: 632 -4353
Reg #: LIC 41650
FEES REQUIRED INSPECTIONS
Description Date Amount Sprinkler Underslab Inspec
[BUILD] Permit Fee 10/10/200 $148.90 Sprinkler Rough In
[TAX] 8% State Tax 10/10/200: $11.91 Sprinkler Final
[FLS] FLS Pin Rv 10/10/200: $59.56
Total $220.37
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling 3) 246 -•: •9 or 1- 800 - 332 -2344.
Issu d By: 1 „ -.-,_/ A
Permitte
Signature: ;i , //, rf « �� .
7 Call 639 -4175 by 7 p.m. for an inspection the next business day
Fire Protection stem
h B
0 .SW qa' v e f oP G.O. , may k
/Sp 6 NvRo rt • _ f+OIt OFFICE USE ONLY- '
I + uilding Permft Ap'pJik atton Received �7� Building
. � Date /By: % / (0 Q-7 , Permit No.: .0 640510 jQl X
city of Tigard Planning Approva Other
y g OCT 1 p 2003 Planning
Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By --7-0'� fr Permit No.: ��
Phone: 503-639-4171 Fax: �03� 5 811 RD / " ' l l " Post Re yew Land Use %
Internet: www.ci.ti dDU1LDING DIV SIO �. Date /By: Case No
ar.or.0 4.
g Contact �'�` ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name /Method: / r a Supplemental Information
e ,..,m , -..kt^ ` .. . , - _ .._ _• - :-.;:. .:e - :,u;�„a;t,,. " u:�t"•m`?s:: <i{� x;n'. *:; + +a�. '* :,�::M- 'ti = € i .
,,.. .TYPE OR°W. z ix ;
.,����: <r �� . ° � . s -. . =� .. A. QULRED DAT , t 1
RE
[K�New construction El Demolition �� 1 & 2FY D,\ELLI_NG ,
❑ Addition/alteration/replacement ❑ Other: .
r, ='�" r "�A ' S . R U� ; , . , N ote: Permit fees* are based on the total value of the work
��r�;..",n ,'�_� ",,_� ., GATEGORl 'OF:G,ONSTRiJGTION,�, =;; �, _ performed. Indicate C p
❑ 1 & 2- Family dwelling ❑ Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
❑ Accessory Building ❑ Multi Family
❑ Master Builder ❑ Other: Valuation $
7t) `'� ,tia JOB SITE. INFO ani1LOCATION' .,_.E No of bedrooms: No of baths:
Job site address: , / 7 5O 5- w , '9 8 Et -4 "E Total number of floors r-
New dwelling area (sq. ft.) (1
Suite #: Bld • . /Apt. #: Garage /carport area (sq. ft.)
Project Name: — 66.4e° 4441.e¢eey o F GD.D Covered porch area (sq. ft.) F
Cross street/Directions to job site: Deck area (sq. ft.) _ _ _
Other structure area (sq. ft.) '\
Sw
.. I4 rr.3e,RL.Y Pe.,
R , ° DATA * " ,
u a
COVIMERCL USE „CEECKLIST ”
Subdivision: Lot #:
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
• I K;a �,N,.., »_ Oti �°S C- I RI ° """ ' C; , tt ;t.. the value (rounded to the nearest dollar) of all equipment, materials, labor,
' uEa „s`.DESCPTIONYOFWORI --
T overhead and profit for the work indicated on this application.
„T PooS T48.,L Ft GC seAta•JKLeeS
/ N Hef-+ 4flwu s- 'wn v P�cCs
r,, cp
Valuation $ /O $(p0 ° —
Existing building area (sq. ft.) /199✓
(E X 7F 4, o. o F E Ti.✓G SY& 0 — ) New building area (sq. ft.) Z. 94:10 J Number of stories 1
% WitikOmizofritaw,NERWAilM A M AUISTAINVENAAMW:.:„ „NA Type of construction
Name: Occupancy group(s): Existing:
New:
Address:
City /State /Zip:
Phone: pox NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
4 ® F APELIYCANT .. ;E,.`� t.� E., :. , . CONTACTP ` M
�” prov of ORS 701 and may be requ to be l i n the
Business Name: A f oFesa t 49 flee £it7E Po. Gr, jurisdiction where work is being performed. If the applicant is exempt
Contact Name: rr e..4 . eiei2. y - from licensing, the following reason applies:
Address: / 7Z 7 3 S. S'ft pet. .
City /State /Zip: BEA vE EE o,e , 9 7rc te
Phone:$b3- 43z-y3S3 Fax: 6.32- 98 35" r �
*/ BUILDING PERMIT FEES 4 ” ,
E E-mail: s 5I � _A Pleaserefer to fee Mhedul V M�
- . , .. ' (CONTRACTOR 4" :E.. e `� , ' at q; i! ., . _.... E.:_. :,.s..:_ F... ; ha 00,...i:..,,.: A.
Business Name:A P f N to &mt. Fi& S) 'PAms 4 Fees due upon application $ '
Address:
City /State /Zip: S-4c I••.. C Amount received $
Phone: Fax: Date received:
CCB Lic. #: 4'/6 ,5 6 - ,/ .-cP.5
Authorized �� Notice: This permit application expires if a permit is not obtained within
Signature: � 1 A
Date: /0 , -0 3 180 days after it has been accepted as complete.
/ le.t 3F *Fee methodology set by Tri -County Building Industry Service Board.
(Please print name)
is \Dsts \Permit Forms\BldgPermitApp.doc 01/03
5 001.-3903
L
Fire Protection Permit Check List
Describe work to be done:
A.) 'la1 New • ` : •• =, Modification to sprinkler heads only:
Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
•
• Additional description of work:
•
° S`TA.L, Fier 5re, N1(.eQ SYsrei A-rftio
l ,
E or 1C I s rr nl c. S y s. s.71-
Type of System (Complete A, B, C or D as applicable):
e .
A °Commerelit$pr nkl • , ... _ a_ _.:.
Wet ail- Dry ❑
Additional Standpipes
Information: Hazard Group» " : - • • ..1.:-.•G'K•T"
Density /CD
Design Area • • / Sco'
K. Factor �.
q Sprinkler Project Valuation: $ f'cY
_B:) .T .Hood FireSuppression,�Syste;mM,,.T ,�..•, � ,.. _ .... •�.. �"�`�,`
Hood Project Valuation: $
�C_)_;Fire ,���.. ,.:..• �.y{ ._.
Submittal shall Battery Calculations . - ; - Y.es.
• „; •;' include: Individual Component Yes ❑ •
Cut Sheets
Fire Alarm Project Valuation: $
D 1, NResrdent 110rmkler tStand Alone,S .stem) ° 15k
Square Footage: Permit Fee:
0 to 2,000 $18750 ' V.
2,001 to 3,600 $ 232.50
3,601 to 7,200 •• °$292:50
7,201 and greater $381.50 y;5 .v ° -ti` •
Sprinkler Project Square Footage : ?6, sq.
Project Valuation Subtotal (A, B. & C): ' $
Permit fee based on valuation (see attached chart): $
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8 % Permit`Fee:''
FLS Plan Review 40% of Permit Fee: $
TOTAL: $' • '' --
Plan review requires a completed application and 3 sets of plans at submittal.
Plan review fees are required at submittal.
fire protection systems require that plans bear the original seal of an
licensed fire suppression engineer, or NICET level "3" technicians.. ' • '
is \dsts \forms \FPSchecklist.doc 02/28/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION.DIVISION Business Line: (503) 639 -4171 MST
Received Date Re uested 7( PM BUP
Location ( 4 75 �9t 4L, Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ((^^) SWR
BUILDING Tenant/Owner I \"�' ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fire all
ire S rinkler
Fire Alarm
Susp'd Ceiling
Roof ,
I pr.
/LW
160 .
. � PART FAIL vir
BING ttw �►`,
Post & Beam
UnderSlab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post& Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRIC AL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please cal or reins.ection RE: El Unable to inspect — no access
Fire Supply Line
Approach/Sidewalk Date L � � Inspector Ext
Other:
Final DO N • T REMOVE this inspection record from the Job site.
PASS PART FAIL